罗库溴铵对丙泊酚麻醉诱导气管插管时熵指数的影响  

Effect of rocuronium on entropy to endotracheal intubation during propofol anesthesia induction

作　　者：王秀莹[1] 黄科昌[1] 黄昌雪[2] 何翠[2] 李建花[3] 

机构地区：[1]潍坊医学院附属医院麻醉科,261031 [2]潍坊医学院附属医院手术室,261031 [3]潍坊医学院附属医院检验科,261031

出　　处：《中国医师进修杂志》2009年第5期14-16,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价罗库溴铵对丙泊酚麻醉诱导气管插管时熵指数的影响。方法丙泊酚靶控输注麻醉诱导患者40例，随机分为0．6mg／kg罗库溴铵组（R组）和0．9％NaCl溶液组（s组），每组各20例。麻醉诱导2～3min后快速气管插管。记录麻醉诱导前（Ta）和诱导后（Tb）、静脉注射罗库溴铵或0．9％NaCl溶液后2min（Te）、气管插管后即刻（To）、气管插管后1、2和3min（T1、T2、T3）时反应熵（RE）和状态熵（SE）。结果T2时S组RE—SE高于R组。气管插管可致RE和sE升高。与T0比较，R组和s组在T2时sE分别由50±8降至42±7和55±12降至43±13。RE由54-I-9降至45±6和66±15降至48．4-16（P〈0．05）。Tn时S组RE和RE—SE明显升高。结论罗库溴铵影响RE—SE以及RE和RE—SE对气管插管的反应，神经肌肉阻滞药物可能会干扰气管插管时熵指数的监测。Objective To evaluate the effect of rocurouium on entropy to endotracheal intubation during anesthesia induction with propofol. Methods Forty patients anesthetized induction with propofol using a target-controlled infusion were randomly divided into two groups： rocuronium group （R group, 20 cases） received 0.6 mg/kg rocuronium or saline group iS group, 20 cases） received saline. 2-3 min later, endotracheal intubation was performed. Response entropy（RE） and state entropy（SE ） were recorded during baseline（Ta）, at steady state（Tb）, 2 rain after rocuro nium or saline administration （To） and 0, 1, 2 and 3 min after endotracheal intubation （T0, T1, T2, T3）. Results At T2, the RE-SE was higher in S group than that in R group. Endotraeheal intubation induced increasing in RE and SE. Comparing T2 and To values in R group and S group,. SE increased from 42 ± 7 to 50 ± 8 and 43± 13 to 55 ±12, and RE increased from 45 ± 6 to 54 ± 9 and 48 ±16 to 66 ±15, respectively. At Te, RE and RE-SE were higher in S group. Conclusion Rocuronium affects RE-SE and RE and RE-SE responses to endotraeheal intubation and may confound interpretation of entropy monitoring.

关 键 词：插管法 气管内 二异泊酚 熵 罗库溴铵 

分 类 号：R614[医药卫生—麻醉学]